The co-responder way: mental health professionals and officers team up
Bothell-Kenmore Reporter - 6/4/2019
A welfare check call came in at 10 a.m. and by the time Susie Kroll came on duty with her partner at 4 p.m., the man still hadn't been located. They drove to the subject's house and knocked on the door. His lights were on, but they couldn't see anyone inside. It was silent.
Kroll is a mental health professional (MHP) patrolling the streets and riding passenger in Eastside law enforcement patrol vehicles. The call was in 2017 and one of the first calls Kroll responded to in a co-responding model.
As the pair were preparing to leave they were approached by the landlord. He had a key to get inside and offered to let them in.
"And I said 'Okay,'" Kroll relates in her retelling of the story. "And my partner said, 'Actually, not okay. We can't do that there's no exigency.'"
They had to have proof he was inside, and they couldn't just bust in, breaking landlord-tenant laws and a person's privacy rights. Kroll didn't know that as an MHP.
Then they learned the man was in fact inside and in danger.
The door was barricaded, but the deputy kicked it in. They found the man blue, unresponsive and on the floor. He had been sober for 20 years and injected six doses of heroin into himself. At that point and time the King County Sheriff's Office was not carrying Narcan — a nasal spray that could help reverse an opioid overdose.
"But me, as a mental health professional, was," Kroll said.
She dosed him with Narcan before emergency responders arrived and the man's life was saved after being dosed multiple times by responders.
On her own, Kroll wouldn't have entered the house, and she may have broken the law if she attempted to, she said. Her partner could get inside, but didn't have the Narcan needed, nor the time to wait for fire and EMS to arrive.
"We needed to both be there," she said. "And on almost all the calls we go on, we needed to both be there."
Eastside law enforcement departments are working to better address the crises they encounter, repeat emergency callers and to aid those with barriers to help by utilizing a co-responder model — one that partners a mental health professional with law enforcement agents.
At six local locations, it's Kroll who is patrolling the streets with a law enforcement officer.
"This is the perfect marriage of well-trained, well-educated really conscientious deputies and officers doing work in partnership with an MHP who has the license and training to be able to mesh the cultures and respond in our fields of expertise," Kroll said.
It wasn't Kroll's initial intent to do this kind of work — the kind that combines the intersections of mental health with the atmosphere and danger that comes part-and-parcel with the professional life of a deputy.
She already had a full-time job when she was approached by a party intent on implementing a co-responder program in Shoreline. It was funded by a Department of Justice grant, and the terms of the funds necessitated the department find someone who could do the work. The MHP would also have to pass a criminal background check, polygraph and drug test. Finding a candidate was difficult.
Kroll initially turned down the job offer but said she was happy to help fill in as they continued their search. She started part time at the King County Sheriff's office for Shoreline in 2017.
"And then it spiraled into six departments," Kroll said.
She works as the co-responding MHP for law enforcement departments of Bothell, Kirkland, Lake Forest Park, Kenmore, Shoreline and Redmond.
While these kinds of partnerships may be newer to the Eastside, the model has been replicated by law enforcement agencies in Los Angeles — where there is a bonafide multi-year program — and Portland, Ore., which not only uses MHPs on its crisis intervention team but also sends them out with patrol as a resource. The Seattle Police Department, too, has its own MHP.
"There are very few, but there is a changing tide to see the value in having that," Kroll said.
Repeat emergency callers are among the many things the partnership works to address.
There's a myriad of reasons why someone would repeatedly call 911 for help. Sometimes someone becomes intoxicated and calls 911, or someone reaches out with continued domestic violence complaints. Others go into a crisis and don't have distress tolerance or the needed coping skills.
"What have we all been taught since we could speak?" Kroll said. "When you're in trouble you call 911. This is where you call for help"
There's no one way to address repeated callers. Kroll said typically she and her partner will respond and learn more about the problem and then attempt to put the services in place that would mitigate that crisis from happening again.
"So that the default coping mechanism isn't to call 911, it's to call a case manager, a doctor or an after-hours crisis line," Kroll said. If a person calls back after having access to the new resource, it may be a different type of call, which to her still shows a progression of wellness.
A lot of times, Kroll said, people find themselves in crisis due to an unaddressed medical issue. So they'll work to get people insurance and into primary care to address the chronic medical condition that may be exacerbating a mental health issue.
Others are diverted away from jail, because their problems are better addressed with mental health or medical treatment. She offered the hypothetical example of someone caught doing low-level theft from a store, stealing only toilet paper, tooth brushes and other basic necessities.
"We can try to get those needs met, and then the low-level theft stops," she said.
Kroll said she isn't doing anything to circumvent accountability for any crime, but rather she's giving people the power and autonomy to make different choices, while still taking responsibility for their past choices. However, she added, placing someone in jail, caught stealing because they don't understand, isn't going to solve the problem.
A Vera Institute of Justice 2015 report found that "an estimated 14.5 percent of men and 31 percent of women in jails have a serious mental illness (SMI) such as schizophrenia, major depression and bipolar disorder, compared to 5 percent of the general population."
Other times there's a de-escalation. Recently Kroll responded to a call of a woman who had reported a sexual assault. She had climbed into her clothing dryer and was refusing to come out. She wouldn't come out for officers, or the sergeant, but she came out for Kroll.
Kroll's been a full-time MHP in Redmond since November of last year. She's worked alongside police officers as a tool for emergency call response. Other times Kroll gets a referral and she spends her time making a home visit or placing a phone call. She'll venture to hospitals, RVs, cars being lived out of and meet with those living in tents.
On May 16, Kroll and Redmond Officer Natalie D'Amico were partnered. They had worked together before that Thursday and could recant stories where D'amico chased a suspect and Kroll was left behind to guard the police vehicle.
Sometimes Kroll offers a suspect description when backup arrives. Other times she jumps into "tactical trunk monkey" mode and hands equipment off to her partner.
They agreed their partnership is seamless, often taking non-verbal cues from each other.
"I find (the partnership) very helpful," D'amico said. "I'm not an MHP. I don't have the training and skill set that she has."
Kroll stood out in her office waiting for a call to come in that morning. Wearing black body armor, she was a stark contrast to the bright objects on her desk and pastel-colored inspirational photos on her wall. Written on the photos were phrases like "light tomorrow with today" and "carpe diem."
She isn't a cop. She'll be the first to say it when she arrives at a scene.
"My first line isn't 'Hey what's your name?'" Kroll said. "I'm usually like, 'I'm Susie. I'm a counselor, not a cop.'"
Due to the nature of police calls and Kroll being unarmed in a police car, she has to wear body armor. But in place of the white words "police" are the words "mental health professional." And instead of weapons she carries a flashlight, "because that's helpful," she said. Pens, "because all I do is write," sometimes she writes statements and reports for hospitals, if there are involuntary treatment requests.
She has Narcan, first aid and a little plastic wand filled with water, glitter and stars. It's proved helpful for kids when they're scared.
She also carries lip gloss.
Regardless, people are sometimes at first suspect of Kroll because of the uniform.
D'amico said sometimes the uniform deters others from talking to her. They may have had a bad interaction with law enforcement in the past or been arrested before, so someone in a uniform can be "scary" or "upsetting." But in instances where she takes a step back and allows Kroll to try and make contact, it can have an 180-degree affect.
"I know this is alarming looking, and just so you know you're not in trouble with me," Kroll will typically assure those she contacts. "You can't get in trouble with me, because I'm just a counselor."
She'll make sure to follow through in doing what she says she will, in an attempt to build trust and rapport with people. When she hands her business card out and tells others to call her, she'll make sure to answer.
"Sometimes it doesn't work. Sometimes people are just not interested because of who I'm partnered with," Kroll said. "But by and large, I get more relief and more thankfulness from folks we see together than I get push back."
A permanent place
Seeing the value the co-responder model brings, law enforcement agencies are already laying the groundwork to make MHP's a permanent part of their departments.
In Kirkland, voters approved Resolution 5324 in 2018, which allocated $120,000 to a full-time mental health professional.
The city of Bothell passed both of its public safety initiatives last November, allowing for a full-time manager and MHP for the city's Navigator mental health program.
If Kroll had her way, she said the MHP role would be the norm rather than the exception at all departments, "so that it is a position someone can apply for and have the stable work, allowing a partnership to flourish between the MHP and officers."
The nature of an MHP being a temporary role at certain departments can make it harder to find people to fill the positions, she added. It's hard to pull professionals from full-time jobs with benefits to do hourly work with no benefits or retirement support.
If it were included in a department's budget — rather than being grant funded and temporary — it wouldn't be something officials would have to locate resources for. It would be similar to the finances used for patrol cars and ambulances for first responders, considered integral for the city.
"It doesn't have to be a program we grow accustomed to, that does really good work and then has to disappear because the funding runs out or the grant term is over," Kroll said.
Kroll's position is funded at the Redmond Police Department until the end of the year. But officials are hoping more permanent funding will be put in place for the resource. The department has already seen positive results with individuals suffering from mental health issues and the need for the model continues to become more obvious, Redmond Police Captain Ron Harding said.
"While our officers receive comprehensive training in appropriate response to people with mental health issues, the level of service we can provide with the assistance of an experienced MHP is unrivaled," Harding said. "Society's expectations of what mental health services should be are high, and the co-responder model is one way we can be successful."